PROJECT SUMMARY The research in this K99/R00 Pathway to Independence Award is aligned with the National Institute of Nursing Research?s scientific focus area of improving self-management strategies for individuals with chronic conditions. Additionally, this award will provide the protected time, advanced training, and research experience that the candidate needs to further develop her program of research aimed at promoting health and reducing health disparities among Latinos with low health literacy. This study builds on previous NIH-funded pre- and postdoctoral research (T32 NR013454, T32 NR007969) and aims to evaluate infographics which are evidence-based, culturally appropriate, and methodically designed images to facilitate clinician-patient HIV-related communication. HIV is a complex chronic illness for which effective self-management requires persons living with HIV (PLWH) to acquire, understand, and utilize large amounts of health information. By using rigorously designed and evaluated infographics during clinical encounters, clinicians may provide the information PLWH need for effective self-management in a more meaningful way. During the first year of the K99, the candidate will assess the extent to which the infographics she developed through her postdoctoral work are a feasible and useful method to facilitate information exchange and improve outcomes among PLWH with low health literacy. To ensure cultural relevance, this feasibility trial of infographic use during clinical visits in a limited resource setting will take place at Clnica de Familia in La Romana in the Dominican Republic (DR). Beyond ensuring cultural appropriateness, this study builds on previous work conducted at the Clinic and a well-established relationship with the organization will ensure long-term project success. The second year of the K99 will take place at Columbia University School of Nursing in New York City, and will include advanced training in statistical analysis, design and implementation of randomized controlled trials (RCTs), theory and measurement of acculturation and cultural influences on health, communication methods with individuals who have low health literacy, and automation of infographics through coursework, seminars, and interdisciplinary collaboration. During the R00 phase, a multi-site RCT will be used to assess the efficacy of using infographics during normal clinic visits to improve short, medium, and long- term treatment outcomes among PLWH in the United States (US) and in the DR. How infographic use influences clinician-patient communication and treatment outcomes in both settings will also be compared. Through rigorous refinement and evaluation of a novel method to enhance HIV-related communication between health care providers and Latino PLWH with low health literacy in the US and abroad, findings will contribute to the evidence- base regarding methodically generated, culturally appropriate infographic design and communication methodologies that can lead to better health outcomes among Latino patients globally. Additionally, by ensuring the time and support needed to solidify her program of research, this award will advance the candidate towards becoming an independently funded nurse scientist seeking to promote health and reduce health disparities through evidenced-based informatics interventions.